Provider Demographics
NPI:1285719245
Name:GOISMAN, ROBERT MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:GOISMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 GREENOUGH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6156
Mailing Address - Country:US
Mailing Address - Phone:617-939-6299
Mailing Address - Fax:
Practice Address - Street 1:370 WASHINGTON ST
Practice Address - Street 2:#7
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6874
Practice Address - Country:US
Practice Address - Phone:617-939-6299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA442652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA54410Medicare UPIN